| NPI | 1013154004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9397265) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN562789) |
| 363L00000X Nurse Practitioner (Licence: PA SP010096) | |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2021-03-30 |